Life With Herpes: Tips for Healthy Sex - Everyday Health

If you've recently been diagnosed with herpes, you're not alone. About 1 in 8 people ages 14 to 49 in the United States has this sexually transmitted disease (STD), according to the Centers for Disease Control and Prevention (CDC).

Genital herpes is caused by one of two viruses: herpes simplex type 1 or 2. People with the infection typically experience occasional outbreaks of painful sores or blisters around their genitals. But not everyone with herpes has symptoms, and this can make it tricky to stop the spread of the disease.

The good news is that it's possible to have an enjoyable sex life when you have herpes, although how and when you have sex may change at times as a result of your diagnosis. Read on to learn what you can do to protect your own health and that of others.

Make Sense of Your Diagnosis

It can be stressful to learn that you have genital herpes, especially when you're experiencing an outbreak for the first time. What's more, "People can feel angry or distrust their partners," says Lynn Yee, MD, a maternal fetal medicine specialist and the director of the Northwestern Medicine Women's Infectious Disease Program in Chicago.

But even if it's your first outbreak, Dr. Yee notes, you may not have acquired herpes recently. That's because once the virus enters your body, it can hide and become inactive, or latent, in an effort to avoid your immune system's defenses, as described by the American Sexual Health Association. In latent genital herpes, the virus retreats to nerve roots (ganglia) at the base of your spine.

Genital herpes can develop after any form of sexual contact involving your genitals. In many cases, there is no way to know if your sexual partner has herpes — viral shedding can occur without any visible or noticeable symptoms. And your partner may not know that they have herpes, either. "It's important to take a step back and not blame yourself, and not necessarily your partner either," Yee emphasizes.

While herpes can come with shame and stigma, this shouldn't be the case, Yee laments. "It's an infection like any other. Yes, it's sexually transmitted, but we manage it like any other medical condition," she says.

Communicate With Your Partner

If you have herpes, be open and honest about it with any sexual partner. "Communicating about it helps people use barrier protection and avoid sex when they're having symptoms, and that helps the partner stay negative," or free of herpes, says Yee. But communication is about more than just knowing when to avoid sex or use protection — it's about defining your values and priorities when it comes to herpes.

"If it's of very high value to an individual to do everything they can to avoid [herpes], then they should use barrier protection all the time," says Yee, noting that for most couples, barrier protection means using male condoms.

But for some couples, the benefit of not using condoms most of the time outweighs the small risk of getting herpes when your partner is free of any symptoms. This small risk adds up over time, though, so that in a long-term relationship, "There's a really high chance of the negative partner acquiring herpes," she cautions. This risk can be reduced by taking a daily medication to suppress the herpes virus (more on this later).

While it may be reasonable for many people to accept some risk of getting herpes from a long-term partner, "This is a very individualized decision that a couple should make," says Yee. She urges anyone who may want to become pregnant to "talk to your doctor or midwife" about the risks related to getting herpes, since there is a small chance of passing herpes to your newborn baby, which can carry serious health risks. But even though as many as 1 in 4 pregnant women may have genital herpes in the United States, fewer than 0.1 percent of all babies get the infection, the American Sexual Health Association cites.

If you're wondering how to tell your partner that you have herpes, here are some tips for navigating the conversation from the American Sexual Health Association. Make sure to disclose that you have herpes before any sexual activity with a new partner.

Manage Outbreaks and Prevent the Spread

For most people with herpes, treatment consists mainly of managing outbreaks of the disease — periods in which the virus becomes active and symptoms develop. This can begin with what are known as prodromal symptoms, according to Yee — typically itching, tingling, or numbness in the genital area before any sores or lesions are present. If you have either prodromal or more significant visible symptoms, "Avoid contact with someone else's genitals, even with condoms, until those symptoms have resolved," Yee urges.

Many people with herpes are prescribed an antiviral drug to take when an outbreak occurs. This treatment can shorten the duration of an outbreak, and should begin at the first sign of prodromal symptoms or within one day of a lesion developing, according to the CDC. A few different drug regimens are prescribed for this type of treatment, involving one of the three currently approved antiviral drugs for herpes.

For people who experience frequent herpes outbreaks or have significant symptoms when an outbreak occurs, a daily dose of an antiviral drug to prevent outbreaks — known as suppressive therapy — may be recommended. Taking the medication daily can also prevent the spread of herpes to a sexual partner, even for people who don't experience herpes symptoms or outbreaks, says the CDC.

Besides taking medications as needed, "Anything that increases chronic stress increases your susceptibility to infection and recurrence" of herpes, says Yee. While there isn't much evidence that any stress reduction techniques could reduce the risk of having an outbreak or spreading herpes to your partner, Yee notes that "it's a good idea to try to reduce stress," as well as follow a healthy diet, stay physically active, and get enough sleep.